- Westborough Behavioral Healthcare Hospital (Westborough, MA)
- …for a UR Specialist to provide Per Diem coverage. Job Description: The Utilization Review Specialist is responsible for monitoring adherence to the ... hospital's utilization review plan to ensure the effective...experience. + 2-3 years experience working as a UR Specialist , Medical Billing or health care quality assurance. +… more
- Deloitte (Boston, MA)
- …clinical registered nurse, physician, physician assistant, case manager, clinical documentation specialist , utilization review , informatics RN, Quality, DRG ... Healthcare Clinical Documentation Specialist - Senior Consultant Our Deloitte Regulatory, Risk...financial concerns and other business controversy. A Clinical Documentation Specialist (CDS) works to ensure accuracy and completeness of… more
- Beth Israel Lahey Health (Cambridge, MA)
- …the Director of Quality & Patient Safety, the Quality and Patient Safety nurse specialist plays a role in reviewing publicly reported quality data by leading the ... the key performance indicators and quality measures, the RN specialist also aims to foster a culture of safety...patient outcomes. The nurse works with clinical staff to review clinical charts, interpret data, and implement quality improvement… more
- Novo Nordisk (Boston, MA)
- …appropriate patients that would benefit in order to ensure early trial and utilization + Generates advocacy for Novo Nordisk products and services by sharing ... exceeding the Novo Nordisk points threshold assigned based on review of Motor Vehicle Records. Qualifications + Bachelor's or...this job family are as follows: * Cardiometabolic Care Specialist , Hep/Gi I - $95,000 to $117,000 * Cardiometabolic… more
- Datavant (Boston, MA)
- …The purpose of the Denial Prevention Specialist is to effectively defend utilization of available health services, review of admissions for medical necessity ... author appeal letter Identification of referrals to the medical director for review + Select appropriate preferred and contracted providers + Provide proper… more
- Pfizer (Boston, MA)
- …lives. **What You Will Achieve** The Gastroenterology Health & Science Sales Specialist is responsible for launching new products, deciding upon best strategies to ... and Key Opinion Leaders (KOLs). The Gastroenterology Health & Science Sales specialist should possess customer, market and business acumen combined with strong… more
- Tufts Medicine (Melrose, MA)
- …role is essential in developing and maintaining an infrastructure for the systematic review and management of complex patients. The position will work closely with ... managers, TMIN Practice Optimization Coaches (POMs) and primary care providers to review patient records, analyze data, and identify practice and patient outlier … more
- CVS Health (Boston, MA)
- …We have an exciting opportunity available for highly motivated individuals as Medicare Sales Specialist . The position will be a part of a specialized team who will ... all sales presentations. + Servicing of existing members and inquiries related to utilization of their product, benefits, etc. + Cross selling applicable products to… more
- Sedgwick (Boston, MA)
- …Fortune Best Workplaces in Financial Services & Insurance (Remote) EDI Support Specialist - Casualty **PRIMARY PURPOSE** **:** To identify, research, resolve, and ... Support Representatives on a variety of complex issues including expert review of International Association of Industrial Accident Boards and Commissions (IAIABC)… more
- World Insurance Associates, LLC. (Waltham, MA)
- …plan services, and payroll & HR solutions. Position Summary The Broking Specialist receives and processes submissions for business from a network of insurance ... Market segment. + In conjunction with other team members, prepare, review , and approve client-ready documentation, including proposals, analysis, and coverage… more